Provider Demographics
NPI:1497213953
Name:WHITMORE, SEASON VIRGINIA (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:SEASON
Middle Name:VIRGINIA
Last Name:WHITMORE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1423 RED VENTURES DR
Mailing Address - Street 2:
Mailing Address - City:INDIAN LAND
Mailing Address - State:SC
Mailing Address - Zip Code:29707-5019
Mailing Address - Country:US
Mailing Address - Phone:704-244-3716
Mailing Address - Fax:
Practice Address - Street 1:801 W TRADE ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28202-1122
Practice Address - Country:US
Practice Address - Phone:980-598-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-04
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC22697363LF0000X
NC5011727363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily